According to UNICEF, India accounts for almost 20 per cent of the world's maternal mortality cases but the Janani Suraksha is making a difference.

Guddi Vishambhar emerges from her mud home, cradling a baby son delivered safely thanks to a new hotline that is slashing maternal mortality rates in a corner of India where they had remained stubbornly high.

Three months ago, the 25-year-old from Dharmpur village in Rajasthan went into labour in a country where a woman dies from pregnancy complications every seven minutes.

But fearful of giving birth at home, far from medical help, she called the "Janani Suraksha" or "Safe Motherhood" helpline.

A taxi arrived and ferried her to the nearest clinic an hour away, where Sachin was born after a difficult delivery.

"If it wasn't for the helpline, I don't know what would have happened," said Guddi. "I was bleeding a lot and don't think I or Sachin would be healthy if I had given birth at home."

Rajasthan, best known for its resplendent desert forts and its colourful festivals, also shoulders a less impressive distinction -- one of the highest maternal death rates in India.

According to the United Nations Children's Fund (UNICEF), India accounts for almost 20 per cent of the world's maternal mortality cases: 301 for every 100,000 live births in 2006.

But across the deserts of Rajasthan, low literacy, poor infrastructure and poverty drive that ratio up to 445 per 100,000 births, according to a 2001-2003 government survey.

"Most of the deaths are avoidable and are caused by poor nutrition, no antenatal care, home births where complications arise and poor access to health clinics," said Pavitra Mohan, health project officer for UNICEF in Rajasthan.

Second-class delivery

An hour away from the Taj Mahal -- the most famous monument dedicated to a woman who died in childbirth -- scores of women in Guddi's Dholpur district continue to die needlessly every month.

In dusty villages, kids play in pools of muddy water among basking buffaloes, old women sweep their homes and white-turbaned men laze on wood and jute beds discussing the mustard crop.

An economic boom that is transforming India's cities is largely invisible here.

In Revai village, about 100 km southwest of the marble mausoleum built by Mughal emperor Shah Jahan in 1648 in memory of his wife Mumtaz, another family laments the death of a mother in childbirth.

Thirty-three-year-old Muni died in August 2005 when eight months pregnant, leaving behind her husband and four children.

"She was bleeding and had severe pains in her abdomen but we didn't know what to do," said her brother-in-law, Murari Harijan.

"There was no vehicle to take her to the hospital. She died here at home in the village."

Poverty and poor transport and health infrastructure force 70 per cent of the district's women to deliver at home, where maternal deaths are common due to haemorrhaging, eclampsia, infections and related conditions such as anaemia.

"People here think that if a pregnant woman has pain or bleeding it is normal, and that it will go away," said S D Mangal, a local gynaecologist. "But they are wrong."

The Janani Suraksha initiative, set up by local charity Manglam Seva Samiti and backed by UNICEF, is making a difference in Dholpur, but there's a long way to go.

Forty cars are now on call across 170 villages in the district's Badi area, which used to report 30-40 maternal deaths a year. In the last 12 months there have been just eight.

"We can't build clinics in all the villages, but the helpline ensures we get expectant mothers to the nearest one as quickly as possible," says the charity's Ashok Tiwari, adding government officials hope to extend it to other parts of the state.